Variations around the skills mix in care homes

Care homes for older people

The Care Inspectorate is aware of the challenges faced by some care providers on the recruitment and retention of nurses in the care sector. Some care providers have approached us about reconfiguring their staffing model, to develop the role of their senior care workers so that they can deploy their nurses more effectively and in some cases reduce reliance on agency nursing in order to promote more stable staff teams.

The Care Inspectorate recognises and strongly supports the role that nurses play in many care homes, particularly in providing clinical leadership and planning care for residents. We are also keen to support innovation in care that reflects changing needs and demands, where this improves outcomes for service users.

Where care homes for older people are proposing to vary the skills mix in a care home, and this would require a change to staffing schedules, we will consider proposals through our registration variations process. We expect such proposals to improve the quality of care for residents. We will ask care homes to provide us with specific information to support the variation request.

If agreed, we may place specific time-limited conditions on the registration of the service. We will expect any such initiative to be evaluated by the care home provider, before consideration is given to confirming these arrangements as permanent. Where a variation is agreed, the next inspection of the care home is likely to look at all quality themes, even if the home has been performing at a high level for some time.

Prior to submitting your variation, the Registration Team will be able to advise on what actions you should be taking to support your application. This should include engagement with local commissioners, as well as with residents and relatives and the development of a plan to evaluate the impact and effectiveness of your initiative. Please note, cost saving will not be an acceptable reason for application.